Coughing. Antifungals.

Species: DogBreed: Lab crossAge: 5-8 years

My seven year old, male Lab cross, Nero, has a strange condition that I have not been able to fully remedy.

It began around two months ago when he was clearly unwell, totally listless, lay in bed all day and wouldn't eat. My vet confirmed he had a fever and put him on a course of antibiotics for five days and also gave him an antibiotic injection.

Two days later he seemed much better, was eating again, following me about like my shadow, like he always does, showing signs of being better, but he began coughing several times every day.

I took him back to the vet and she told me to continue with the antibiotics for a total of ten days, fearing he had kennel cough. His coughing at that time was a unique, strange cough. He would go cough, cough, cough, Ha-AAAAAAAAACKK as though he was trying to bring something up from within his throat. He would also bring up a clear, slightly frothy white liquid from time to time.

At this point let me add that I have two dogs, his sister, who has been his companion since they were born, is absolutely fine and does not show any signs of any trouble.

Ten days passed and his cough was no better, although he was now eating fine and running about absolutely normally in every other way.

His cough seemed to get much worse at night and towards the early morning, when he would have several bouts of coughing while we (tried to) sleep, sometimes as much as 6-8 times per night.

I spoke to a friend who is a vet and who has two Labs who have shown similar symptoms for the past two years, but he has not been able to cure them either. He told me that it might be some sort of oesophageal or stomach reflux, so we treated him with stomach pills for around 6-7 days. These are pills commonly used for acidity and similar gastric problems. As a precaution I also swapped his choker style collar to a harness for his walks.

The cough didn't improve and he started purging and occasionally vomiting so I stopped that course of treatment.

I then took him to a third vet who did a bunch of tests on him, blood test, throat x-ray, chest x-ray, ECG, 2D Echo of the heart, and even a test where they shoved a scope down his throat and had a look about.

He told me that everything with his heart appeared normal but the throat scope showed signs of a fungal infection. There were no tumours or blockages found in his throat. His blood test was normal except for slightly lower than reference thyroid levels.

He gave him a steroid shot and a lasi lactone shot and told me to give him some anti fungal pills. Over the next day or two his cough appeared to be much better.

He has had 20 days of anti-fungal treatment, during which the cough seemed to imrove but the long hacking continued from time to time. He has been off all meds for nearly a month now and his cough is a bit worse than it was before. He seems to cough when he gets excited. I've also noticed that his breath has a funny smell that it never used to have. It's like a meaty, slightly rotten smell, not overpoweringly bad, but certainly not pleasant either.

In every other way, he seems normal now, is perfectly happy and plays with his sister, runs about and does normal dog things.

What would you suggest I do, going forward? Could this be just the end of a fungal infection and does he need more pills? Could it be something else?

Thanks for taking the time to read this long message.

Dr. Marie replied:

What an interesting case...although I'm sure this is quite frustrating for you. It is always difficult when we have to do a whole bunch of tests. And quite often we do those tests and still don't have an answer. It is encouraging that the vet was able to see signs of a fungal infection.

A fungal infection is not common. And, it's not something that is likely to be diagnosed by accident. In other words, it sounds like this really is the crux of the problem. Also, the fact that things started improving once the antifungal pills started is really good.

With that said, it's possible that it was the steroid shot that caused the improvement and not the antifungal medicine.

It sounds like more tests are in order. I would highly suggest that you followup with the vet who diagnosed the fungal problem. They may decide that he needs a longer course of medicine. Sometimes fungal conditions can take months to fully clear up. Or, what might be a better (but more expensive) option would be to repeat some tests. I would probably want to be doing some chest xrays to see if there is obvious spread of fungal disease in the lungs as this can be quite serious. And, I might possibly be wanting to do something called a transtracheal wash to get a sample from the respiratory tract so that I could test again to see if there is fungus there.

Some fungal diseases can be very difficult to clear up. It's possible that he needs a different type of antifungal medicine.

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Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

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